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Just another PLM WordPress siteThu, 01 Dec 2016 17:42:05 +0000en-UShourly1https://wordpress.org/?v=4.6.1Philadelphia Employment Lawyers: Paid Sick Timehttp://www.ezoldlaw.com/2015/10/philadelphia-employment-lawyers-paid-sick-time/
http://www.ezoldlaw.com/2015/10/philadelphia-employment-lawyers-paid-sick-time/#respondMon, 19 Oct 2015 16:24:01 +0000http://www.ezoldlaw.com/?p=345On August 3, 2015, the Pittsburgh City Council amended the city’s code to add the “Paid Sick Days Act.” The Act, which will become effective on January 11, 2016, is expected to benefit more than 49,000 employees. The Act requires employers with 15 or more employees to provide its employees with 1 hour of paid sick leave for every 35 hours worked, up to a maximum of 40 hours, of paid sick leave per year. For employers with less than 15 employees, the Act requires Continue reading →

]]>On August 3, 2015, the Pittsburgh City Council amended the city’s code to add the “Paid Sick Days Act.” The Act, which will become effective on January 11, 2016, is expected to benefit more than 49,000 employees. The Act requires employers with 15 or more employees to provide its employees with 1 hour of paid sick leave for every 35 hours worked, up to a maximum of 40 hours, of paid sick leave per year. For employers with less than 15 employees, the Act requires up to 24 hours of unpaid sick leave for the first year after the ordinance becomes effective. After January 11, 2017, employers with less than 15 employees will be have to provide their employees with up to 24 hours of paid sick time. The Act allows employees to take leave to care for their own illness or to care for their spouse, domestic partner, child, parent, grandparent or sibling. The Act does not provide mandatory sick leave for state and federal employees, members of a construction union covered by a collective bargaining agreement, or seasonal employees or employees who already receive paid sick leave equivalent to that contained in the Act.

Pittsburgh joins Philadelphia to become the second major city in Pennsylvania to require paid sick leave for its employees. Philadelphia passed a similar ordinance in February 2015 which requires employers with 10 or more employees to provide employees with 1 hour of sick time for every 40 hours of work.

]]>http://www.ezoldlaw.com/2015/10/philadelphia-employment-lawyers-paid-sick-time/feed/0Philadelphia Health Care Lawyers: New Home Care Overtime Rules Start Next Weekhttp://www.ezoldlaw.com/2015/10/new-home-care-overtime-rules-start-next-week/
http://www.ezoldlaw.com/2015/10/new-home-care-overtime-rules-start-next-week/#respondTue, 13 Oct 2015 14:37:49 +0000http://www.ezoldlaw.com/?p=344 by Melanie Bork Graham, Esq.and Christopher Ezold, Esq. The US Department of Labor (DOL)’s Fair Labor Standards Act (FLSA) regulations extending overtime to home care workers will take effect on October 13. While DOL first issued the new regulations in 2013, industry groups challenged the new regulations in federal court. The regulations were upheld on appeal. The Home Care Association of America and the national Association for Home Care and Hospice then filed an emergency petition to the US Supreme Court to delay the Continue reading →

The US Department of Labor (DOL)’s Fair Labor Standards Act (FLSA) regulations extending overtime to home care workers will take effect on October 13.

While DOL first issued the new regulations in 2013, industry groups challenged the new regulations in federal court. The regulations were upheld on appeal.

The Home Care Association of America and the national Association for Home Care and Hospice then filed an emergency petition to the US Supreme Court to delay the regulations pending a full appeal. The groups argued that the changes would create unrecoverable costs and cause disruption in the continuity of care with hour caps to control overtime.

On October 6, the Supreme Court denied the request to postpone.

The new rules that take effect on October 13 will affect 2 million health care workers nationwide, including home health aides, personal care aides and certified nursing assistants. DOL stated they will not begin enforcement before November 12 and thereafter will use prosecutorial discretion with consideration given to good faith efforts to comply.

This development underscores the changing landscape of the relationship between home health care workers and the services that place them. Treating these workers as ‘independent contractors’ comes with increasing risk (i.e. government agencies or workers lawsuits finding that the workers are really ‘employees,’ which results in very significant financial penalties and costs for the employer/service). Treating these workers as ‘employees’ comes with increasing cost (i.e. ACA/health insurance compliance, overtime, etc.). Ensuring compliance while managing cost is going to be an increasingly important task for all home health care businesses.

The new regulations underscore the need for a compliance analysis of how the rules affect operations, scheduling, payroll and budget projections and competent implementation.

]]>http://www.ezoldlaw.com/2015/10/new-home-care-overtime-rules-start-next-week/feed/0Philadelphia Health Care Lawyers: State and Federal Pull Away from Fee-For-Servicehttp://www.ezoldlaw.com/2015/10/state-and-federal-pull-away-from-fee-for-service/
http://www.ezoldlaw.com/2015/10/state-and-federal-pull-away-from-fee-for-service/#respondMon, 05 Oct 2015 15:28:24 +0000http://www.ezoldlaw.com/?p=341by Melanie Bork Graham, Esq. Health policy wonks and the quality movement have long championed the shift away from fee-for-service to payment models that ‘align incentives with outcomes.’ But alternative payment models are based on predictions rather than services rendered, and can have significant ramifications for the sustainability of any practice. Common alternative payment structures include: 1) bundled payments, where one payment covers multiple services for an episode of care (common in obstetrics); 2) capitation, such as a global payment per patient per month regardless Continue reading →

Health policy wonks and the quality movement have long championed the shift away from fee-for-service to payment models that ‘align incentives with outcomes.’ But alternative payment models are based on predictions rather than services rendered, and can have significant ramifications for the sustainability of any practice.

Common alternative payment structures include: 1) bundled payments, where one payment covers multiple services for an episode of care (common in obstetrics); 2) capitation, such as a global payment per patient per month regardless of services rendered (think PCMH); 2) pay for performance, which includes a bonus for data showing quality or cost of care; and 3) shared risk models, which share a portion of savings on a patient panel with the physician or cause the provider to incur responsibility for the cost of any care over budge (think ACO).

In the last year the payors have made significant moves away from fee-for-service. Amongst commercial payors, only 11% of provider payments were value-based in 2013.[1] One year later the percentage of value-based payments nearly quadrupled, accounting for 40% of all provider payments in 2014.[2]

This month, agencies at the federal and Pennsylvania state levels have initiated further moves to alternative payment models. The Pennsylvania DHS issued an RFP for health services provided through the mandatory Medicaid managed care program, HealthChoices, that requires MCOs to migrate 30% of their provider contracts to alternative payment models within 3 years. Options include ACOs, bundled payments, PCMHs and pay for performance models.

On September 28, 2015, CMS announced the notice and comment period for rulemaking on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)[3] better known as the Medicare SGR repeal. Most agree that repealing the SGR and eliminating the annual threat of double digit payment cuts to physicians was a good thing. But there is some uncertainty over the “payment modernization” under MACRA which includes up to 9% payment cuts under the Merit Payment Incentive System (MIPS) and 25% participation in alternative payment models.

Negotiating and complying with fee-for-service payor contracts is complex. The shift away from fee-for-service will raise a host of new issues. We will report as the rulemaking and RFP provide details on Medicare/Medicaid alternative payment models and the impact on physician practices in Pennsylvania.

]]>http://www.ezoldlaw.com/2015/10/state-and-federal-pull-away-from-fee-for-service/feed/0Philadelphia Employment Lawyers Discuss Marriage Equality and Employee Benefitshttp://www.ezoldlaw.com/2015/09/philadelphia-employment-lawyers-discuss-marriage-equality-and-employee-benefits/
http://www.ezoldlaw.com/2015/09/philadelphia-employment-lawyers-discuss-marriage-equality-and-employee-benefits/#respondMon, 14 Sep 2015 14:40:44 +0000http://www.ezoldlaw.com/?p=339In June 2015, the United States Supreme Court legalized same-sex marriages across the country. Members of the LGBT community, however, still face many legal battles regarding how this ruling will be implemented in individual states. One of the biggest questions that still needs to be answered is how the ruling will affect the benefits packages an employer provides to its employees. Impact on Employee Benefit Packages The Supreme Court decision will impact employees’ benefits packages in several ways. First, if prior to the Supreme Court’s Continue reading →

]]>In June 2015, the United States Supreme Court legalized same-sex marriages across the country. Members of the LGBT community, however, still face many legal battles regarding how this ruling will be implemented in individual states. One of the biggest questions that still needs to be answered is how the ruling will affect the benefits packages an employer provides to its employees.

Impact on Employee Benefit Packages

The Supreme Court decision will impact employees’ benefits packages in several ways. First, if prior to the Supreme Court’s ruling a company extended benefits to heterosexual spouses, it will be expected to extend those same benefits to homosexual spouses. The decision also likely will impact coverage for domestic partnerships; employers may now require that employees be married in order to be eligible to receive benefits which could adversely affect those employees who do not wish to take the “public” step of getting married to their partners. For those employers who provide to their employees fully-insured medical plans, the Court’s decision mandates that same-sex spouse coverage be added to those plans (though this would not necessarily apply for self-insured plans). Finally, following the ruling, insurance provided through Medicaid and the federal insurance marketplace will be expanded to include same-sex marriage coverage.

Employment Rights

Same-sex couples who marry are not automatically granted the protection of the employment discrimination laws. Most states’ employment discrimination laws do not yet include provisions related to married, homosexual couples. Employers should be aware that the U.S. Equal Employment Opportunity Commission has taken the position that employment discrimination against LGBT employees violates the sex discrimination provisions of Title VII of the Civil Rights Act of 1964.

What’s Next for Employers?

Employers across the nation must ensure that their benefits packages are structured in ways that meet the new requirements, or they may be exposing themselves to potential litigation. Employers are free to expand, reduce and restructure benefits plans for their employees, but they must remain compliant with the law. In order to do so and to best minimize litigation risks, employers will need to update their handbooks and revise internal benefits enrollment processes and forms to reflect these changes in the law.

Philadelphia Employment Lawyers Provide Legal Counsel for Companies in Pennsylvania and New Jersey

]]>http://www.ezoldlaw.com/2015/09/philadelphia-employment-lawyers-discuss-marriage-equality-and-employee-benefits/feed/0Philadelphia Health Care Lawyers: Latest Supreme Court Ruling on the Affordable Care Acthttp://www.ezoldlaw.com/2015/07/philadelphia-health-care-lawyers-latest-supreme-court-ruling-on-the-affordable-care-act/
http://www.ezoldlaw.com/2015/07/philadelphia-health-care-lawyers-latest-supreme-court-ruling-on-the-affordable-care-act/#respondWed, 15 Jul 2015 17:38:03 +0000http://www.ezoldlaw.com/?p=337In June, 2015, the United States Supreme Court decided to uphold the Affordable Care Act (ACA) tax subsidies for both state and federal health exchanges. Six justices were in favor of the decision. The Court’s ruling should ensure the survival of the ACA until after the 2016 presidential election. The Affordable Care Act Survives Another Supreme Court Ruling The case called into question whether customers of the federal marketplaces in 34 states were eligible to receive federally funded subsidies to help pay for their insurance Continue reading →

]]>In June, 2015, the United States Supreme Court decided to uphold the Affordable Care Act (ACA) tax subsidies for both state and federal health exchanges. Six justices were in favor of the decision. The Court’s ruling should ensure the survival of the ACA until after the 2016 presidential election.

The Affordable Care Act Survives Another Supreme Court Ruling

The case called into question whether customers of the federal marketplaces in 34 states were eligible to receive federally funded subsidies to help pay for their insurance premiums. The original wording of the law specified that subsidies were available for individuals purchasing plans on exchanges “established by the state.” If the Court had ruled against the subsidies, more than six million Americans would have lost assistance to pay for their health insurance.

Challengers to the law argued that the specific wording, “established by the state,” meant that the IRS could not authorize subsidies for state exchanges and that the wording was an intentional incentive for states to set up their own exchanges. Proponents of the law disagreed, saying that the intentions of Congress were to make

The Court upheld the current interpretation of the law. Chief Justice John Roberts was part of the majority and backed his decision by stating that “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.” Roberts continued his statement saying, “The context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

After the majority opinion was read, Justice Antonin Scalia read the dissenting opinion. Justice Samuel Alito and Justice Clarence Thomas joined in the dissent which was heated. Scalia said it was not the job of the Supreme Court to fix a poorly-drafted law. He even went so far as to mention that rather than being called “Obamacare,” the ACA should be referred to as “SCOTUScare,” due to the ruling.

President Obama spoke from the White House after the Court’s decision was announced, saying, “We finally declared that in America, healthcare is not a privilege for a few, but a right for all. The Affordable Care Act is here to stay.”

Philadelphia health care lawyers at The Ezold Law Firm, P.C. represent a diverse group of health care companies and providers with health care, employment and business law challenges arising from both state and federal laws. We serve clients in New Jersey, Pennsylvania and represent clients nationally for legal claims in the federal court system. Please call 610-660-5585 today or fill out our online form to schedule a consultation.

]]>http://www.ezoldlaw.com/2015/07/philadelphia-health-care-lawyers-latest-supreme-court-ruling-on-the-affordable-care-act/feed/0Philadelphia Business Lawyers: No Cyber Liability Coverage for Knowing Refusal to Release Datahttp://www.ezoldlaw.com/2015/06/no-cyber-liability-coverage-for-knowing-refusal-to-release-data/
http://www.ezoldlaw.com/2015/06/no-cyber-liability-coverage-for-knowing-refusal-to-release-data/#respondMon, 15 Jun 2015 16:11:56 +0000http://www.ezoldlaw.com/?p=331by: Melanie Bork Graham, CIPP/US Last month, one of the first courts to address coverage under a cyber liability policy held that allegations of refusal to release data to a customer did not trigger a duty to defend the insured for technology errors and omissions liability. In Travelers Property and Casualty Company of America v. Federal Recovery Services et al., Travelers filed a declaratory judgment action to determine its obligation to defend its insured Federal Recovery Services, Inc. Federal Recovery was in the business of Continue reading →

Last month, one of the first courts to address coverage under a cyber liability policy held that allegations of refusal to release data to a customer did not trigger a duty to defend the insured for technology errors and omissions liability.

In Travelers Property and Casualty Company of America v. Federal Recovery Services et al.,Travelers filed a declaratory judgment action to determine its obligation to defend its insured Federal Recovery Services, Inc. Federal Recovery was in the business of processing, storage and transmission of electronic data for its customers. Federal Recovery had a CyberFirst Policy with Travelers that provided a duty to defend the insured against any claim applicable to the cyber liability forms for “errors and omissions wrongful act.”

Federal Recovery processed and maintained member account payment data for its client, Global Fitness under a servicing agreement. Global Fitness entered into an asset purchase agreement with L.A. Fitness that included transfer of all Global Fitness’ member account data to L.A. Fitness.

Global Fitness claimed that when it requested the data Federal Recovery refused to release the data without compensation beyond that provided for in the servicing agreement. Global Fitness asserted multiple claims including conversion, tortious interference, and breach of contract but no claim of negligence.

Travelers accepted Federal Recovery’s defense under a reservation of rights and filed the declaratory judgment action arguing that Global’s allegations of a knowing, willful and malicious withholding of data where not covered by the errors and omissions policy for negligent acts. The opinion does address whether the policy had an intentional acts exclusion; presumably because Travelers did not make this argument. The court simply held the allegations did not sound in negligence.

The Federal Recovery case underscores the need for insured businesses to understand what their cyber policy covers and whether that coverage applies to actual risk. According to the 2015 Verizon report, malicious insiders are the top third cause of data breaches globally. These internal employee threats are motivated by financial incentives to sell data or use it to compete with the employer (Verizon, 2015). If particular cyber policy language excludes coverage for intentional, knowing and malicious acts companies may have no coverage for third party suits arising out of a major cause of most breaches.

In the current environment every company will likely experience a breach at some point whether it be healthcare or retail. Data security is a now a necessary cost of doing business. Obtaining the proper cyber coverage is a best practice in risk management undertaken with a trusted broker and counsel.

]]>http://www.ezoldlaw.com/2015/06/no-cyber-liability-coverage-for-knowing-refusal-to-release-data/feed/0Philadelphia Healthcare Lawyers: Medical Marijuana in Pennsylvania – Potential Issues for Employershttp://www.ezoldlaw.com/2015/04/medical-marijuana-pennsylvania-potential-issues-employers/
http://www.ezoldlaw.com/2015/04/medical-marijuana-pennsylvania-potential-issues-employers/#respondFri, 03 Apr 2015 06:00:54 +0000http://www.ezoldlaw.com/?p=314Marijuana laws are changing rapidly across America; right now there are 24 states permitting the use of marijuana for medical uses when prescribed by a physician (and 18 states with pending legislation to do the same), there are 14 states that have decriminalized marijuana (substituting fines for jail time) (and 17 states with pending legislation to do the same), and there are 4 states that legalize and regulate marijuana like alcohol (and 16 states with pending bills to do the same). Pennsylvania has pending bills Continue reading →

]]>Marijuana laws are changing rapidly across America; right now there are 24 states permitting the use of marijuana for medical uses when prescribed by a physician (and 18 states with pending legislation to do the same), there are 14 states that have decriminalized marijuana (substituting fines for jail time) (and 17 states with pending legislation to do the same), and there are 4 states that legalize and regulate marijuana like alcohol (and 16 states with pending bills to do the same).

Pennsylvania has pending bills to legalize both medical marijuana and recreational use of marijuana. The medical marijuana bill, designated Senate Bill 3 (SB3), has broad bipartisan support, the expressed support of the governor and is substantially in the same form as a bill that was passed by the Pennsylvania Senate in 2014. SB3 contemplates becoming effective in 2015; there is a significant chance that it will pass and become effective in 2015 or soon thereafter.

If SB3 passes as drafted, what does this mean for employers in Pennsylvania? SB3 not only allows for medical marijuana use, but prohibits employer discrimination against medical marijuana cardholders in hiring or termination of benefits, and prohibits employers from “otherwise penalize[ing]” an employee for being a cardholder. What ‘otherwise penalizing’ means, however, is not defined.

This prohibition does not apply if the employer can “prove abuse or misuse” of cannabis on premises during business hours, or if failure to discriminate would impact federal licensing. Furthermore, positive drug tests for cannabis cannot be considered by an employer unless the employee unlawfully used, possessed or was impaired by medical cannabis while on premises during hours of employment. Therefore, the employer cannot consider medical cannabis use ‘off the clock’ nor pre-employment.

SB3 does prohibit the use of cannabis when operating vehicles or heavy machinery, if use would be ‘negligence’ or professional malpractice, smoking or vaporizing cannabis or adulterating cannabis. These issues can be considered by an employer in making employment decisions. However, what is ‘negligence’ or ‘professional malpractice’ may not be readily apparent using common sense; consulting with an employment attorney in such situations is recommended.

Even if SB3 passes, medical marijuana is still illegal under federal law – therefore, it is unlikely that the Americans with Disabilities Act would come into play. Pennsylvania’s Human Relations Act (“PHRA”), which prohibits discrimination against employees with disabilities – including the use of prescribed medications to deal with those disabilities – may be an issue, however. As the courts interpret the PHRA consistently with the ADA, however, it remains to be seen whether and how the PHRA will come into play. If the courts decide that the PHRA does apply to employee use of medical marijuana, the scope of that protection will be unclear at first. Currently, SB3 limits the number of medical conditions for which a physician can prescribe marijuana – but allows for a regulatory expansion of those conditions upon petition by a physician. This means that the number of potential employees who may be using medical marijuana will increase over time, and that they will each have a high probability of having a related disability protected by the PHRA.

This introduces a difficult problem for employers: how to engage in the deliberative process with an employee to identify whether an accommodation is possible for medical marijuana use. Under the PHRA, an employer can generally wait for an employee to initiate the process; however, the current medical marijuana legislation does not explicitly include any accommodation language – but provides a blanket prohibition on discrimination. Therefore, it would be wisest to ensure that when medical marijuana use is known to the employer, the employer should initiate the discussion regarding accommodation. The question remains whether treating the users of medical marijuana in this fashion somehow discriminates against other disabled employees – does this conservative approach open the door to requiring the employer to initiate the discussion for all disabilities with all employees under both state and federal law? The answer to this question won’t become clear for some time.

Furthermore, if SB3 passes, employers should ensure that they have a solid, straightforward medical marijuana policy, tailored to their industry and operations, and enforced uniformly. If any preferential treatment is provided under the policy, it may open the door to claims of discrimination by other employees – i.e. if younger employees are treated deferentially by the employer, but older employees have to jump through more hurdles to comply with the employer’s medical marijuana policy, the older employees may have an age discrimination claim. Furthermore, although use of alcohol and illegal drugs on the job can result in termination, regardless of any addiction-related disability, medical marijuana will no longer fit within that category.

It appears clear that there are significant changes to marijuana laws coming to Pennsylvania – we will keep our readers updated on how these new laws impact employer’s obligations and employee rights.

]]>http://www.ezoldlaw.com/2015/04/medical-marijuana-pennsylvania-potential-issues-employers/feed/0Philadelphia Healthcare Lawyers: Will the Antibiotic Resistance Action Plan Affect Your Practice?http://www.ezoldlaw.com/2015/04/will-antibiotic-resistance-action-plan-affect-practice/
http://www.ezoldlaw.com/2015/04/will-antibiotic-resistance-action-plan-affect-practice/#respondThu, 02 Apr 2015 14:54:16 +0000http://www.ezoldlaw.com/?p=311-By Melanie Bork Graham Last week the White House issued a National Action Plan for Combating Antibiotic-Resistant Bacteria. It is laudable that the administration is calling attention to this issue and requesting additional funds to fight it. Even in the lay press it is well recognized that anti-microbial resistance is a significant public health threat. It is estimated that at least 2 million illnesses and 23,000 deaths are caused each year by antibiotic resistance.[1] But the plan may be focusing on the wrong actors. The Continue reading →

Last week the White House issued a National Action Plan for Combating Antibiotic-Resistant Bacteria. It is laudable that the administration is calling attention to this issue and requesting additional funds to fight it. Even in the lay press it is well recognized that anti-microbial resistance is a significant public health threat. It is estimated that at least 2 million illnesses and 23,000 deaths are caused each year by antibiotic resistance.[1] But the plan may be focusing on the wrong actors.

The plan’s five main goals include improved surveillance of outbreaks, faster diagnostic tests at the point-of-care, and antibiotic stewardship programs in healthcare settings. The plan also calls for government agency tracking of antibiotic consumption to “reduce inappropriate use in people and animals.” In a WebMD interview, President Obama stated that “…a lot of America’s antibiotic use is unnecessary” and “[i]f we can see where these drugs are being overprescribed, we can target our interventions were they’re needed most.” This begs the question whether the federal government will move to mandate reporting of antibiotic prescribing in the Medicare and Medicaid populations.

The plan also supports eliminating the indiscriminate use of antibiotics that are medically important for humans in food animals to promote growth. But the problem with this plan is that focus is unbalanced. The vast majority of antibiotic use in this country is not in the human population, but in agriculture. Indeed 51 tons of antibiotics are consumed daily in the U.S. and 80% of it is in the agriculture vertical.[2] Specifically, the majority of antibiotics are used in livestock production.

As shown in the diagram below, the application of antibiotics from cradle to grave to promote growth in food animals creates the antibiotic resistant bacteria because it routinely kills the bacteria that are weak.

The human exposure pathway is through the surrounding environment and somewhat less in contaminated food sources.[3]

This issue is not new. The Swann Committee report in the U.K. identified routine use of antibiotics in animal husbandry as a human health hazard in 1970. Around the same time the U.S. Food & Drug Administration commissioner established a task force to analyze the problem. It took some time, but in 2012 and 2013 FDA issued Guidances for Industry to limit the herd wide use of antibiotics in food animals. However, presently, the Guidances are voluntary.

Perhaps the focus of the antibiotic resistance may be better aimed at the 80% of antibiotics being used herd wide in livestock regardless of illness instead of the less than 20% being administered to the human population. Saddling physicians with antibiotic prescribing protocols, reporting and tracking may be more trouble than it is worth in the long run.

]]>http://www.ezoldlaw.com/2015/04/will-antibiotic-resistance-action-plan-affect-practice/feed/0Philadelphia Healthcare Lawyers: The Physician’s Right to Practice Evidence-Based Medicinehttp://www.ezoldlaw.com/2015/03/philadelphia-healthcare-lawyers-discuss-physicians-right-practice-evidence-based-medicine/
http://www.ezoldlaw.com/2015/03/philadelphia-healthcare-lawyers-discuss-physicians-right-practice-evidence-based-medicine/#respondMon, 16 Mar 2015 23:49:03 +0000http://www.ezoldlaw.com/?p=308By Melanie Bork Graham Very simply, in Pennsylvania doctors do not have to treat patients who refuse vaccinations for themselves or their children. Why is this important? Because Pennsylvania’s immunization rate is the second lowest in the country at 87%[1]which is not sufficient to retain herd immunity – for instance, herd immunity for MMR requires 92-95% immunization.[2] Herd immunity is the ability of a community to fight off infectious disease as a “herd” by vaccinating a certain percentage of the population. Vaccinating at the herd Continue reading →

Very simply, in Pennsylvania doctors do not have to treat patients who refuse vaccinations for themselves or their children.

Why is this important? Because Pennsylvania’s immunization rate is the second lowest in the country at 87%[1]which is not sufficient to retain herd immunity – for instance, herd immunity for MMR requires 92-95% immunization.[2]

Herd immunity is the ability of a community to fight off infectious disease as a “herd” by vaccinating a certain percentage of the population. Vaccinating at the herd immunity level protects more medically vulnerable members from infectious disease when they themselves cannot take advantage of the vaccine due to cancer treatment or because they are too young.

This has serious real-world implications; for instance, the Centers for Disease Control and Prevention (CDC) recently stated that the measles outbreak in Disneyland has now spread to Pennsylvania, where a case was reported in Cumberland County. With compromised herd immunity, the incidence of active measles threatens medically vulnerable people in that community and potentially throughout Pennsylvania.

Lower vaccination rates are absolutely correlated with looser immunization laws that allow residents to opt-out of vaccinations. Our Commonwealth is one of those states. Pennsylvania has a philosophical exemption to vaccination that is very broad, allowing almost anyone opt-out if they have a “strong conviction” against vaccination.

Happily there are both personal and structural level solutions to the problem of compromised herd immunity in Pennsylvania. From a personal perspective, individual doctors can take a stand for evidence-based policies to combat the public health threat of infectious disease in the context of their own practices. Broadly speaking, under the AMA code of medical ethics, a physician is free to choose whom to serve and can refuse to form a physician-patient relationship if the physician so chooses – including refusing to work with patients who refuse vaccinations for themselves or their children.

Existing physician-patient relationships can be terminated, under Pennsylvania law, as long as the physician supports the patient’s continuity of care. This choice may also have practical wellness effects for the physician’s patients, as they will be less likely to be exposed to an unvaccinated carrier at the physician’s offices.

As a high level policy response to this issue, the Pennsylvania Senate’s Committee on Public Health and Welfare approved Resolution Number 27 for an advisory committee to study and report on how to increase child vaccination rates in Pennsylvania. At the same time, lawmakers in both houses of the General Assembly announced that they would introduce legislation to eliminate the philosophical exemption to vaccination.

Proponents of the bills expect bi-partisan support in both chambers and note that the anti-vaccination movement in Pennsylvania has not been as highly organized as some states. Lawmakers in California, Illinois, Vermont and Maine have also proposed to introduce similar legislation.

Regardless of how one feels philosophically about the state mandating personal action, doctors have every right to insist on patient compliance with evidence-based vaccination protocols.

]]>http://www.ezoldlaw.com/2015/03/philadelphia-healthcare-lawyers-discuss-physicians-right-practice-evidence-based-medicine/feed/0Philadelphia Employment Lawyers at Ezold Law Firm Discuss New Mandatory Sick Time Lawhttp://www.ezoldlaw.com/2015/02/philadelphia-employment-lawyers-new-mandatory-sick-time-law/
http://www.ezoldlaw.com/2015/02/philadelphia-employment-lawyers-new-mandatory-sick-time-law/#respondThu, 26 Feb 2015 21:07:31 +0000http://www.ezoldlaw.com/?p=305New legislation requiring Philadelphia employers to offer paid sick time for many employees was approved by City Council and signed into law by Mayor Nutter last week. Under the new law, Philadelphia workers will earn one hour of paid sick time for every 40 hours of work. The law applies to businesses that employ ten or more workers, and violations are punishable by restitution, penalties, and fines. The City Council vote was 14-2 in favor of mandatory paid sick time. Supporters emphasize that workers without Continue reading →

]]>New legislation requiring Philadelphia employers to offer paid sick time for many employees was approved by City Council and signed into law by Mayor Nutter last week. Under the new law, Philadelphia workers will earn one hour of paid sick time for every 40 hours of work. The law applies to businesses that employ ten or more workers, and violations are punishable by restitution, penalties, and fines.

The City Council vote was 14-2 in favor of mandatory paid sick time. Supporters emphasize that workers without paid sick time are generally those who need it most. Mayor Nutter previously vetoed two similar bills in 2011 and 2013 due to the city’s financial crisis.

Sixteen other cities across the United States currently have mandatory sick time laws, and President Obama has asked Congress to consider a national law requiring employers nationwide to offer paid sick time to workers.

Philadelphia employment lawyers at The Ezold Law Firm represent employees and employers in all legal matters concerning employment rights. Employees who believe that their employee rights are being violated, or employers needing advice with respect to employment compliance or claims, are advised to contact an experienced Philadelphia employment lawyer at The Ezold Law Firm. Contact us online, or call 610-660-5585 to schedule a confidential consultation.